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Contextualization of the Study of Residual Lesions in Conized Patients

Received: 13 May 2021    Accepted: 31 May 2021    Published: 12 October 2021
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Abstract

In the last years, it is evidenced of more remarkable way, an increment of the incidence of the cervical cancer and their lesions precursors in young patients. Conization, as an excisional method, is recommended in the treatment of high-grade epithelial lesions, as well as in the microinvasive stage of cervical cancer when satisfied parity has not yet been achieved. In Clinical Medicine, finding a balance between therapeutic effectiveness and iatrogenic intervention by exaggerated treatments is a challenge, a current scenario in which the probability of the appearance of residual lesions after conization is framed. Although factors related with the biggest probability of appearance of residual lesions are described in patient conizadas, models that demonstrate the interrelation between these variables don't exist; most of the studies are limited to the individual analysis of these factors. The current scientific evidences allow to state that the appearance of post-cone residual lesions is a multifactorial phenomenon dependent on elements related to the nature of the lesion, the surgical technique and the competence of the surgeon; even several of these predictive elements are interrelated in the same patient. The knowledge of these predictors factors of residual lesion, starting from the pattern of the three dimensions, allows to trace clinical and formative strategies of intervention.

Published in Advances in Surgical Sciences (Volume 9, Issue 2)
DOI 10.11648/j.ass.20210902.14
Page(s) 28-32
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Conization, Residual Injury, Predictive Factors

References
[1] National Inter-Society Consensus on Uterine Cervical Cancer. Rev Argent Radiol 2017; 81 (2): 157-77.
[2] Merlos Gutiérrez AL, Vargas Espinosa JM, González González G, Martínez García M, Sereno Coló JA. Recurrence of cervical intraepithelial lesion in patients after cone resection with diathermic loop. Ginecol Obstet Mex 2016; 84 (2): 95-104.
[3] Moradel MA, Crespin MA, Aguilar O. Conization of the cervix in cervical pathology. Rev Med Hond. 1992; 60: 163-6.
[4] Bermejo W, Vadallares R, Arnais L. Behavior of Conization by Radiosurgery in the Treatment of Preneoplastic Cervical Lesions. Electronic Magazine Medical Archive of Camagüey 2007; 11 (3) [Internet]: http://www.amc.sld.cu/amc/2007/V11n32007/2205.htm] cited July 20, 2008.
[5] Martínez Hiriart BM, Acosta Fernández R, Barrios Rodríguez M, Carbajales León AI. Histological study of conization with diathermic loop in patients with cervical lesions. AMC [Internet]. 2010 Oct; 14 (5). http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552010000500007&lng =en. Cited March 06, 2021.
[6] Jun-Yu C, Zhi-Ling W, Zhao-Yang W, Xing-Sheng Y. The risk factors of residual lesions and recurrence of the high-grade cervical intraepithelial lesions (HSIL) patients with positive-margin after conization. Medicine 2018; 97: 41-8.
[7] Orellana R, Montero de Celis JC, Olguín F, Sánchez F, Muñoz J, Ramírez A, et al. Viral typing in conization follow-up: Prognostic role of the persistence of postcone HPV with loop. Rev Chil Obstet Ginecol 2018; 83 (2): 130–8.
[8] Arbyn M, Redman CH, Verdoodt F, Kyrgiou M, Tzafetas M, Ghaem Maghami S, et al. Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis. Lancet Oncol 2017; 18: 1665–79.
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[11] Menon S, Wusiman A, Boily MC, Kariisa M, Mabeya H, Luchters S, et al. Epidemiology of HPV genotypes among HIV positive women in Kenya: a systematic review and meta-analysis. PLoS One 2016; 11 (10): 1639-65. [Internet]: http://dx.doi.org/10.1371/journal.pone.0163965.
[12] Carcopino X, Mergui JL, Prendiville W, Taranger Charpin C, Boubli L. Treatment of intraepithelial neoplasms of the cervix: laser, cryotherapy, conization, resection with a diathermy loop. EMC - Gynecology-Obstetrics 2012. [Internet]: doi: 10.1016 / S1283-081X (12) 60837-6.
[13] Munro A, Leung Y, Spilsbury K, Stewart C, Semmens J, Codde J, et al. Comparison of cold knife with biopsy and loop electrosurgical excision procedure in the management of cervical adenocarcinoma in situ: What is the gold standard? Gynecologic Oncology 2015; 137: 258-63.
[14] Carvajal Pliego JM, Torres Mendoza RS, González Enciso A, Pérez Montiel D, Lasad F, Cantú de León D. Factors associated with residual disease in the central cone. Gaceta Mexicana de Oncología 2015; 14 (1): 21–7.
[15] Manchanda R, Baldwin P, Crawford R, Vowler SL, Moseley R, Latimer J, Welton K, Shafi M. Effect of margin status on cervical intraepithelial neoplasia recurrence following LLETZ in women over 50 years. BJOG 2008; 115: 1238-42.
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Cite This Article
  • APA Style

    Heenry Luis Davila Gomez, Lidia Esther Lorie Sierra, Zaskia Matos Rodriguez. (2021). Contextualization of the Study of Residual Lesions in Conized Patients. Advances in Surgical Sciences, 9(2), 28-32. https://doi.org/10.11648/j.ass.20210902.14

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    ACS Style

    Heenry Luis Davila Gomez; Lidia Esther Lorie Sierra; Zaskia Matos Rodriguez. Contextualization of the Study of Residual Lesions in Conized Patients. Adv. Surg. Sci. 2021, 9(2), 28-32. doi: 10.11648/j.ass.20210902.14

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    AMA Style

    Heenry Luis Davila Gomez, Lidia Esther Lorie Sierra, Zaskia Matos Rodriguez. Contextualization of the Study of Residual Lesions in Conized Patients. Adv Surg Sci. 2021;9(2):28-32. doi: 10.11648/j.ass.20210902.14

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  • @article{10.11648/j.ass.20210902.14,
      author = {Heenry Luis Davila Gomez and Lidia Esther Lorie Sierra and Zaskia Matos Rodriguez},
      title = {Contextualization of the Study of Residual Lesions in Conized Patients},
      journal = {Advances in Surgical Sciences},
      volume = {9},
      number = {2},
      pages = {28-32},
      doi = {10.11648/j.ass.20210902.14},
      url = {https://doi.org/10.11648/j.ass.20210902.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20210902.14},
      abstract = {In the last years, it is evidenced of more remarkable way, an increment of the incidence of the cervical cancer and their lesions precursors in young patients. Conization, as an excisional method, is recommended in the treatment of high-grade epithelial lesions, as well as in the microinvasive stage of cervical cancer when satisfied parity has not yet been achieved. In Clinical Medicine, finding a balance between therapeutic effectiveness and iatrogenic intervention by exaggerated treatments is a challenge, a current scenario in which the probability of the appearance of residual lesions after conization is framed. Although factors related with the biggest probability of appearance of residual lesions are described in patient conizadas, models that demonstrate the interrelation between these variables don't exist; most of the studies are limited to the individual analysis of these factors. The current scientific evidences allow to state that the appearance of post-cone residual lesions is a multifactorial phenomenon dependent on elements related to the nature of the lesion, the surgical technique and the competence of the surgeon; even several of these predictive elements are interrelated in the same patient. The knowledge of these predictors factors of residual lesion, starting from the pattern of the three dimensions, allows to trace clinical and formative strategies of intervention.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Contextualization of the Study of Residual Lesions in Conized Patients
    AU  - Heenry Luis Davila Gomez
    AU  - Lidia Esther Lorie Sierra
    AU  - Zaskia Matos Rodriguez
    Y1  - 2021/10/12
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ass.20210902.14
    DO  - 10.11648/j.ass.20210902.14
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
    SP  - 28
    EP  - 32
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20210902.14
    AB  - In the last years, it is evidenced of more remarkable way, an increment of the incidence of the cervical cancer and their lesions precursors in young patients. Conization, as an excisional method, is recommended in the treatment of high-grade epithelial lesions, as well as in the microinvasive stage of cervical cancer when satisfied parity has not yet been achieved. In Clinical Medicine, finding a balance between therapeutic effectiveness and iatrogenic intervention by exaggerated treatments is a challenge, a current scenario in which the probability of the appearance of residual lesions after conization is framed. Although factors related with the biggest probability of appearance of residual lesions are described in patient conizadas, models that demonstrate the interrelation between these variables don't exist; most of the studies are limited to the individual analysis of these factors. The current scientific evidences allow to state that the appearance of post-cone residual lesions is a multifactorial phenomenon dependent on elements related to the nature of the lesion, the surgical technique and the competence of the surgeon; even several of these predictive elements are interrelated in the same patient. The knowledge of these predictors factors of residual lesion, starting from the pattern of the three dimensions, allows to trace clinical and formative strategies of intervention.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • Hospital "Heroes’ Baire", Isle of Youth, Cuba

  • Hospital "Aghostino Neto", Guantanamo, Cuba

  • Hospital "Heroes’ Baire", Isle of Youth, Cuba

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